Changes from 2015 to 2016... Rules, Premiums, Plans, Exchanges, Etc.

[AllenChicago]

I am bracing for a ton of those AllenChicago. Family of 4 making $110,000, etc.

2015 coverage is at $800 a month for minimum coverage (6,000 deductible) , going up to $1100 a month most likely in 2016. So $13,200 just on premiums.

Fine for them will be what, $2,100?? If they don't get sick, they win big time. If they do get sick, they pray it is in December and then just sign up for major medical for the following January.

If a STM client gets sick, they can enroll in a QHP with a SEP. The SEP rules are very flexible. Particularly if the client calls into HC.gov and says "I didn't know that my health insurance wasn't ObamaCare compliant! I want to be ObamaCare compliant!!"... You can add yourself as Agent-of-Record with the insurer after the first premium is paid. Worked like a charm for one of my clients back in May. HC.gov's #1 priority 24/7 is to increase ObamaCare enrollment.

----------

Here's a good summary of what consumers will be faced with during the 2016 Open Enrollment, which kicks off just 53 days from today.

Story: How To Prepare For This Year's Open Enrollment Period

Note: Check out the service that the author of the above story has put together. It tells prospects which health insurance plans include their physicians.

Link: Vericred - Solutions

ac

 

[kgmom219]

If a STM client gets sick, they can enroll in a QHP with a SEP. The SEP rules are very flexible. Particularly if the client calls into HC.gov and says "I didn't know that my health insurance wasn't ObamaCare compliant! I want to be ObamaCare compliant!!"... You can add yourself as Agent-of-Record with the insurer after the first premium is paid. Worked like a charm for one of my clients back in May. HC.gov's #1 priority 24/7 is to increase ObamaCare enrollment.

----------

Here's a good summary of what consumers will be faced with during the 2016 Open Enrollment, which kicks off just 53 days from today.

Story: How To Prepare For This Year's Open Enrollment Period

Note: Check out the service that the author of the above story has put together. It tells prospects which health insurance plans include their physicians.

Link: Vericred - Solutions

ac

That's a great article! Thanks for sharing AC

(53 days??? Ugh!)

 

[somarco]

"I didn't know that my health insurance wasn't ObamaCare compliant! I want to be ObamaCare compliant!!".

And that doesn't blow back on you? Guess the folks at goodluck.gov don't really care if the agent 'splained that or not, huh?

 

[AllenChicago]

And that doesn't blow back on you? Guess the folks at goodluck.gov don't really care if the agent 'splained that or not, huh?

Correct Somarco. The Goodluck.gov folks really don't care about the background of any situation. Just tell the "Genie" you want a plan, and your wish will be fulfilled.

This past Spring I had a Coventry client diagnosed with a disease. She wanted to see a specific doctor that was not part of her Coventry network. I told Mary to call HC.gov and ask for a Special Enrollment into Blue Cross, so she could see the physician. In less than 30 minutes, she called me back to say that her enrollment into Blue Cross was complete. HealthCare.gov asked no questions. She just told them that her doctor wouldn't accept Coventry and she wanted Blue Cross. Done!... just like that.

 

[somarco]

The Goodluck.gov folks really don't care about the background of any situation. Just tell the "Genie" you want a plan, and your wish will be fulfilled.

This past Spring I had a Coventry client diagnosed with a disease. She wanted to see a specific doctor that was not part of her Coventry network. I told Mary to call HC.gov and ask for a Special Enrollment into Blue Cross, so she could see the physician. In less than 30 minutes, she called me back to say that her enrollment into Blue Cross was complete. HealthCare.gov asked no questions. She just told them that her doctor wouldn't accept Coventry and she wanted Blue Cross. Done!... just like that.

Amazing.

And agents are busting their butts trying to compete with this AND get paid.

SMH

 

[Sherota1]

If a STM client gets sick, they can enroll in a QHP with a SEP. The SEP rules are very flexible. Particularly if the client calls into HC.gov and says "I didn't know that my health insurance wasn't ObamaCare compliant! I want to be ObamaCare compliant!!"... You can add yourself as Agent-of-Record with the insurer after the first premium is paid. Worked like a charm for one of my clients back in May. HC.gov's #1 priority 24/7 is to increase ObamaCare enrollment.

----------

Here's a good summary of what consumers will be faced with during the 2016 Open Enrollment, which kicks off just 53 days from today.

Story: How To Prepare For This Year's Open Enrollment Period

Note: Check out the service that the author of the above story has put together. It tells prospects which health insurance plans include their physicians.

Link: Vericred - Solutions

ac

Thanks Allen for the link to Vericred- Solutions. It works the state for MD but nit my FFM state. There is another. Thread discussing this product where it cost $24.95. The link is a good look up tool but still not a substitute for the client doing their do diligence and calling their doctors office to be sure they still participate in the plans network. I'll look up a doctor fo a client but I always let them know the ultimate responsibility is theirs since doctors can pull out of networks with little or no notice. Even when they appear on the insurance companies list they still need to check. With that being said it's still a useful tool.

 

[AllenChicago]

9-10-2015

I'm noticing (on SERFF) that health insurance carriers are preparing to send out letters to clients stating that their deductible and OOP are increasing for 2016, to stay compliant with CMS guidelines.

Is it now mandatory that health insurers increase the deductible/OOP? I thought HHS allows higher deductible/OOP ceilings each year, but didn't require health insurers to adjust policies to these higher limits every January.

 

[Yagents]

They are forced to in order to stay within the metal level a.v. ranges. Ex: bcbs az has 5500 then 100% coverage bronze h.s.a plan in 15'. Next year they will have same plan with a 10% coinsurance with o.o.p of 6600. The reason? The 100% plan was too rich for bronze level at 63% or above which is not allowed. They had to add 10% coinsurance to make it between 58-62% which is required by law. Yes, the law requires that they cheapen the plan to make it legal according to a.v. calculator

 

[sman]

Amazing.

And agents are busting their butts trying to compete with this AND get paid.

SMH

Some of us are overachievers Bob.

 

[somarco]

Scott, the good thing about banging your head against a wall is that it feels so good when you stop.